Active NPI
Kimberly Ann Janke
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1386369783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- A15306
- Practice address
- 65 SW Yamhill St Ste 300
Portland, OR 97204-3316 - Phone
- (503) 878-8885
- Fax
- (971) 297-1360
- NPI assigned
- Oct 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SC61557302 | WA | |
| Clinical Social Worker | 1041C0700X | A15306 | OR | Primary |
Addresses
Primary practice location
65 SW Yamhill St Ste 300
Portland, OR 97204-3316
Mailing address
65 SW Yamhill St Ste 300
Portland, OR 97204-3316
Phone (503) 523-0296
Other practice location 1
16100 NW Cornell Rd
Ste 220
Beaverton, OR 97006
Phone (503) 878-8885
Other practice location 2
914 Main Street
Vancouver, WA 98660
Phone (503) 878-8885
Other practice location 3
1200 Executive Pkwy
Ste 260
Eugene, OR 97401
Phone (503) 878-8885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A15306 | OR | MD | Clinical Social Worker |
| SC61557302 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729728000000",
"number": "1386369783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 SW YAMHILL ST STE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972043316",
"telephone_number": "503-523-0296",
"fax_number": "503-523-0296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 SW YAMHILL ST STE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972043316",
"telephone_number": "503-878-8885",
"fax_number": "971-297-1360"
}
],
"practiceLocations": [
{
"address_1": "16100 NW Cornell Rd",
"address_2": "Ste 220",
"address_purpose": "LOCATION",
"city": "Beaverton",
"state": "OR",
"postal_code": "97006",
"country_code": "US",
"telephone_number": "503-878-8885",
"fax_number": "971-297-1360",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "914 Main Street",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "98660",
"country_code": "US",
"telephone_number": "503-878-8885",
"fax_number": "971-297-1360",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1200 Executive Pkwy",
"address_2": "Ste 260",
"address_purpose": "LOCATION",
"city": "Eugene",
"state": "OR",
"postal_code": "97401",
"country_code": "US",
"telephone_number": "503-878-8885",
"fax_number": "971-297-1360",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JANKE",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-07",
"last_updated": "2024-10-24",
"certification_date": "2024-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "SC61557302",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "A15306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.